重症监护病房脓毒症致急性肾损伤患者的危险因素分析

Risk Factor Analysis of Patients with Acute Kidney Injury due to Sepsis in Intensive Care Unit

目的:分析重症监护病房(ICU)内脓毒症致急性肾损伤患者的危险因素。方法:回顾性分析2021年9月—2022年8月河池市人民医院重症医学科诊治的脓毒症患者125例临床资料,根据是否发生急性肾损伤分为非肾损伤组(n=30)和肾损伤组(n=95),并依据急性肾损伤的严重程度将肾损伤组分为肾损伤1组(急性肾损伤1期,n=34)、肾损伤2组(急性肾损伤2期,n=31)和肾损伤3组(急性肾损伤3期,n=30),对各组临床资料进行单因素分析,筛选ICU内脓毒症致急性肾损伤患者的独立危险因素。结果:各组年龄、器官衰竭数目、急性生理与慢性健康(APACHE-Ⅱ)评分、脓毒症相关序贯器官衰竭(SOFA)评分、行机械通气治疗及使用血管活性药物比较,差异有统计学意义(P<0.05);高龄(年龄≥60岁)、器官衰竭数目≥2个、APACHE-Ⅱ评分高、SOFA评分≥2分、行机械通气治疗以及使用血管活性药物为ICU内脓毒症致急性肾损伤的独立危险因素(P<0.05)。结论:高龄、器官衰竭、APACHE-Ⅱ评分、SOFA评分、行机械通气治疗以及使用血管活性药物均与ICU内脓毒症致急性肾损伤有关。

Objective:To analyze the risk factors of patients with acute kidney injury due to sepsis in intensive care unit(ICU).Methods:125 clinical data of sepsis patients treated in Critical Care Medicine Department of the Hechi People's Hospital from September 2021 to August 2022 were retrospectively analyzed and divided into the non-kidney injury group(n=30)and the kid⁃ney injury group(n=95)according to incidence of kidney injury;based on the severity of acute kidney injury,the patients in kid⁃ney injury group were further divided into three groups as followings:renal injury group 1(acute renal injury stage 1,n=34),renal injury group 2(acute renal injury stage 2,n=31)and renal injury group 3(acute renal injury stage 3,n=30);the clinical data of each group were analyzed by one-way analysis to screen the independent risk factors of patients with acute renal injury caused by sepsis.Results:The following factors were compared in all groups:ages,number of affected organ failures,acute physiology and chronic health(APACHE-Ⅱ)score,sepsis-associated sequential organ failure(SOFA)score,application of mechanical ventila⁃tion therapy and administration of vasoactive drugs,and the differences were statistically significant(P<0.05);it showed out that the independent risk factors for acute kidney injury due to sepsis included advanced age(age≥60 years),number of affected organ failures≥2,high APACHE-Ⅱscore,SOFA score≥2,mechanical ventilation therapy,and administration of vasoactive drugs(P<0.05).Conclusion:Advanced age,organ failure,APACHE-Ⅱscore,SOFA score,mechanical ventilation,and application of vaso⁃active drugs were associated with acute kidney injury due to sepsis in the ICU.